When Should You Worry About Cyst Removal?

December 12, 2018

In the past few years, many dermatologists have gotten YouTube famous posting videos of cyst extractions, blackhead removals, and treatments for other common lumps and bumps. For the most part, these videos were intended to discourage amateurs from removing these on their own, but many people are still attempting things like at-home cyst extractions. According to Dr. Lisa Pruett from Trinity Dermatology in Carrollton, TX, “I think it’s important for people to know that lumps and bumps that are present under the skin should always be checked by a dermatologist. If there is a lump or bump that is NEW, or if it is GROWING under the skin, or if it is TENDER or PAINFUL, then it needs to be checked.”

Even if it turns out to be nothing, it’s important to know for sure that your lumps and bumps aren’t something more serious. Below, you’ll find basic information to help you determine whether or not your lump or bump is something to worry about, but when in doubt, call Dr. Pruett or one of the other skilled U.S. Dermatology Partners’ physicians to schedule a consultation.

How will the Dermatologist Treat my Lumps and Bumps?

Before developing your personalized plan to treat or remove skin lumps and bumps, your dermatologist will start by carefully examining the area to determine what it is. Some of the most common types of skin bumps and lesions include:

Skin Cysts

Cysts are common and can occur on all parts of the bodies. They may occur as a result of injury or infection, around a clogged pore, or around a foreign body like a splinter or even a new earring. Cysts are extremely slow-growing, painless, and they feel smooth. Many people describe their cyst as feeling like there’s a pea stuck below their skin. In some cases, a cortisone injection may be enough to shrink the cyst. When cysts become irritated, inflamed, or filled with fluid, don’t respond to cortisone medications, or the cyst is formed around a foreign body, surgical extraction may be necessary.

Open & Closed Comedo

Open and closed comedos, commonly referred to as blackheads and whiteheads, occur when oil and skin cells accumulate and block pores. If the clogged pore remains open, it looks black. Thus, open comedos are referred to commonly as blackheads. A closed comedo is typically white in appearance, thus, they are called whiteheads. In many cases, using different facial cleansers and topical ointments is effective in removing or reducing the numbers of blackheads and whiteheads. In severe cases, you may need to work with a dermatologist to have these comedo professionally extracted.

Cherry Angioma

These skin irregularities typically impact those over the age of 40 and they take their name from the cherry-red coloring of the bump. They are usually smooth to the touch, and cherry angioma may be as small as a pinhead or grow as large as a quarter inch in diameter. Most often appearing on the trunk, you may develop cherry angioma on any part of the body. In most cases, these asymptomatic bumps don’t need to be treated. For those who are concerned about the appearance of cherry angioma, removal options may be available.

Dermatofibromas

These hard, round bumps are reddish-brown colored, and they most often occur following an injury (bug bite, bump or bruise, cut or scratch). Dermatofibromas contain scar tissue, so they will feel hard. Some people describe them as feeling like a BB gun pellet stuck below the skin. Typically asymptomatic, they may cause some itching, pain, or tenderness. We don’t usually need to remove these bumps, but for those whose dermatofibromas are painful, they can be surgically removed.

Folliculitis

This occurs when the hair follicles are inflamed. This can happen after using chemical-laden products or due to physical irritation from chafing clothing, shaving, or other causes of friction against sensitive skin. Folliculitis most often occurs in the hair follicles on the face, scalp, and thighs. While anyone can suffer from folliculitis, those with diabetes, immune-suppressing illnesses, and those who are obese are at greater risk. Treatment usually includes avoiding irritation by wearing loose clothing, avoiding shaving the area, and making changes to shaving methods and products. You may also want to use calming lotion or cortisone cream to relieve the itchiness and inflammation. Some patients experience dramatic improvement in symptoms by simply applying a warm, moist compress to the impacted areas. In some cases, a bacterial or fungal infection may occur in combination with folliculitis and will need to be treated using oral and/or topical antibiotics or antifungals.

Keratosis Pilaris

Keratosis Pilaris looks like “goosebumps” or “chicken skin bumps.” While it may not be attractive, these small bumps that usually appear on the upper arms and thighs, are completely harmless. Treatment is not medically necessary, but there are some topical creams and procedures we can perform to improve the cosmetic appearance of keratosis pilaris, often referred to simply as KP. Most people see a dramatic reduction in the appearance of this condition by the age of 30. Symptoms of KP can also be treated at home by moisturizing and exfoliating regularly.

Lipomas

These are subcutaneous (below the skin) benign soft tissue tumors. The word tumor can be frightening, but lipomas are usually slow-growing and benign. They can occur anywhere on the body, but lipomas most often appear on the neck, shoulders, and trunk. The majority of lipomas are soft, malleable lumps that don’t grow larger than 5 cm in diameter. While they are typically painless, a lipoma may grow large enough to compress nerves in specific areas.

If a lipoma grows large enough to cause cosmetic or functional concerns, we may recommend removal. There are multiple methods available to remove a lipoma, including traditional surgical excision. However, there is a risk for scarring with traditional excision, so we may manually squeeze the lipoma from a smaller incision. We can also use fat-dissolving deoxycholic acid injected into the lipoma to reduce the size of the tumor without the need for more invasive surgical removal.

When Should I Visit a Dermatologist?

If your lesion, bump, or lump isn’t growing and doesn’t itch, hurt, burn, or feel warm to the touch, it’s probably a benign skin condition. Still, we always recommend having new growths or bumps on the skin checked by a professional. Lumps and bumps can be cancerous, and the only way to diagnose that is to biopsy the bump or lesion. Dermatologists are specially trained to know which lump or bump needs to be biopsied, which need to be treated or removed, and which can be left alone.

Why Dermatologists DON’T Recommend Cyst Removal At Home

According to Dr. Pruett, “If you squeeze a cyst (like you can see on many YouTube videos!), it can cause more inflammation and pain. The only time a cyst should be “squeezed” is under the care of a dermatologist who can ensure the procedure won’t cause further inflammation or damage.”

It’s also important for people to understand that squeezing out a cyst’s contents WILL NOT remove the cyst. It only removes the contents inside the lining of the cyst. Dr. Pruett says, “I like to describe it to my patients as a balloon—you can squeeze the air out of the balloon and make it smaller, but the balloon lining is still there. The only way to remove the cyst is to surgically remove the lining.” If you’re dealing with a large cyst or any other lump, bump, or skin lesion, you should always let Dr. Pruett or a U.S. Dermatology Partners professional examine the irregularity and help you with removal when necessary.

Working with U.S. Dermatology Partners

If you need to have one or more lumps or bumps examined by a professional, the U.S. Dermatology Partners can help. Our skilled professionals offer a wide range of treatments to heal your skin, relieve pain or discomfort, and help you look and feel your best. To get started, complete our online request form. One of the U.S. Dermatology Partners team members will be in touch with you soon.